Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Premature Birth | Research

Adverse pregnancy outcomes during the COVID-19 lockdown. A descriptive study

Authors: Eman F. Badran, Rula M. Darwish, Yousef Khader, Rama AlMasri, Mira Al Jaberi, Mohammad AlMasri, Farah AlSa’di, Leen abu Yosef, Noor al-Badaineh

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Login to get access

Abstract

Background

The ongoing spread coronavirus disease worldwide has caused major disruptions and led to lockdowns. Everyday lifestyle changes and antenatal care inaccessibility during the coronavirus disease 2019 (COVID-19) pandemic have variable results that affect pregnancy outcomes. This study aimed to assess the alterations in stillbirth, neonatal-perinatal mortality, preterm birth, and birth weight during the COVID-19 national lockdown.

Methods

We used the data from the Jordan stillbirths and neonatal death surveillance system to compare pregnancy outcomes (gestational age, birth weight, small for gestational age, stillbirth, neonatal death, and perinatal death) between two studied periods (11 months before the pandemic (May 2019 to March 2020) vs. 9 months during the pandemic (April 2020 to March 1st 2020). Separate multinomial logistic and binary logistic regression models were used to compare the studied outcomes between the two studied periods after adjusting for the effects of mother’s age, income, education, occupation, nationality, health sector, and multiplicity.

Results

There were 31106 registered babies during the study period; among them, 15311 (49.2%) and 15795 (50.8%) births occurred before and during the COVID-19 lockdown, respectively. We found no significant differences in preterm birth and stillbirth rates, neonatal mortality, or perinatal mortality before and during the COVID-19 lockdown. Our findings report a significantly lower incidence of extreme low birth weight (ELBW) infants (<1kg) during the COVID-19 lockdown period than that before the lockdown (adjusted OR 0.39, 95% CI 0.3-0.5: P value <0.001)

Conclusions

During the COVID-19 lockdown period, the number of infants born with extreme low birth weight (ELBW) decreased significantly. More research is needed to determine the impact of cumulative socio-environmental and maternal behavioral changes that occurred during the pandemic on the factors that contribute to ELBW infants.
Literature
2.
go back to reference Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, et al. The socio-9 coronavirus and COVID-19 pandemic: a review. Int J Surg. 2020;78:185–93.CrossRef Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, et al. The socio-9 coronavirus and COVID-19 pandemic: a review. Int J Surg. 2020;78:185–93.CrossRef
3.
go back to reference Sahin D, Tanacan A, Erol SA, Anuk AT, Yetiskin FD, Keskin HL, et al. Updated experience of a tertiary pandemic center on 533 pregnant women with COVID-19 infection: a prospective cohort study from Turkey. Int J Gynecol Obstet. 2021 Mar;152(3):328–34.CrossRef Sahin D, Tanacan A, Erol SA, Anuk AT, Yetiskin FD, Keskin HL, et al. Updated experience of a tertiary pandemic center on 533 pregnant women with COVID-19 infection: a prospective cohort study from Turkey. Int J Gynecol Obstet. 2021 Mar;152(3):328–34.CrossRef
4.
go back to reference Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental pathology in COVID-19. Am J Clin Pathol. 2020;154(1):23–32.CrossRef Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental pathology in COVID-19. Am J Clin Pathol. 2020;154(1):23–32.CrossRef
5.
go back to reference Blumberg DA, Underwood MA, Hedriana HL, Lakshminrusimha S. Vertical transmission of SARS-CoV-2: what is the optimal definition? Am J Perinatol. 2020;37(8):769.CrossRef Blumberg DA, Underwood MA, Hedriana HL, Lakshminrusimha S. Vertical transmission of SARS-CoV-2: what is the optimal definition? Am J Perinatol. 2020;37(8):769.CrossRef
6.
go back to reference Haddad LB, Horton J, Ribner BS, Jamieson DJ. Ebola infection in pregnancy: a global perspective and lessons learned. Clin Obstet Gynecol. 2018;61(1):186.CrossRef Haddad LB, Horton J, Ribner BS, Jamieson DJ. Ebola infection in pregnancy: a global perspective and lessons learned. Clin Obstet Gynecol. 2018;61(1):186.CrossRef
8.
go back to reference Paixao ES, et al. Symptomatic dengue infection and the risk of stillbirth in Brazil, 2006–2012: a matched case–control study. Lancet Infect Dis. 2017;17:957–64.CrossRef Paixao ES, et al. Symptomatic dengue infection and the risk of stillbirth in Brazil, 2006–2012: a matched case–control study. Lancet Infect Dis. 2017;17:957–64.CrossRef
9.
go back to reference Clemente NS, Brickley EB, Paixão ES, De Almeida MF, Gazeta RE, Vedovello D, et al. Zika virus infection in pregnancy and adverse fetal outcomes in São Paulo State, Brazil: a prospective cohort study. Sci Rep. 2020;10(1):1.CrossRef Clemente NS, Brickley EB, Paixão ES, De Almeida MF, Gazeta RE, Vedovello D, et al. Zika virus infection in pregnancy and adverse fetal outcomes in São Paulo State, Brazil: a prospective cohort study. Sci Rep. 2020;10(1):1.CrossRef
10.
go back to reference Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: report of two cases & review of the literature Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: report of two cases & review of the literature
12.
go back to reference Alsharaydeh I, Rawashdeh H, Saadeh N, Obeidat B, Obeidat N. Challenges and solutions for maternity and gynecology services during the COVID-19 crisis in Jordan. Int J Gynecol Obstet. 2020;150(2):159–62.CrossRef Alsharaydeh I, Rawashdeh H, Saadeh N, Obeidat B, Obeidat N. Challenges and solutions for maternity and gynecology services during the COVID-19 crisis in Jordan. Int J Gynecol Obstet. 2020;150(2):159–62.CrossRef
13.
go back to reference Uwambaye P, Nyiringango G, Musabwasoni SM, Husain A, Nessa K, Razzaque MS. COVID-19 pandemic: adaptation in antenatal care for better pregnancy outcomes. Front Glob Womens Health. 2020;1:599327.CrossRef Uwambaye P, Nyiringango G, Musabwasoni SM, Husain A, Nessa K, Razzaque MS. COVID-19 pandemic: adaptation in antenatal care for better pregnancy outcomes. Front Glob Womens Health. 2020;1:599327.CrossRef
14.
go back to reference Boelig RC, Saccone G, Bellussi F, Berghella V. MFM guidance for COVID-19. Am J Obstet Gynecol MFM. 2020;2:100106.CrossRef Boelig RC, Saccone G, Bellussi F, Berghella V. MFM guidance for COVID-19. Am J Obstet Gynecol MFM. 2020;2:100106.CrossRef
15.
go back to reference Obeidat AZ, El-Salem K. A national telemedicine program in the Kingdom of Jordan–Editorial. Ann Med Surg. 2021;62:145–9.CrossRef Obeidat AZ, El-Salem K. A national telemedicine program in the Kingdom of Jordan–Editorial. Ann Med Surg. 2021;62:145–9.CrossRef
17.
go back to reference Nair M, Nelson-Piercy C, Knight M. Indirect maternal deaths: UK and global perspectives. Obstet Med. 2017;10:10–5.CrossRef Nair M, Nelson-Piercy C, Knight M. Indirect maternal deaths: UK and global perspectives. Obstet Med. 2017;10:10–5.CrossRef
18.
go back to reference Sullivan E, Marshall D, Li Z, Knight M, Farquhar C, Schutte J, et al. Maternal mortality in high-income countries. J Paediatr Child Health. 2017;53(S2):61. Sullivan E, Marshall D, Li Z, Knight M, Farquhar C, Schutte J, et al. Maternal mortality in high-income countries. J Paediatr Child Health. 2017;53(S2):61.
19.
go back to reference Matheson A, McGannon CJ, Malhotra A, Palmer KR, Stewart AE, Wallace EM, et al. Prematurity rates during the coronavirus disease 2019 (COVID-19) pandemic lockdown in Melbourne, Australia. Obstet Gynecol. 2021;137:405–7.CrossRef Matheson A, McGannon CJ, Malhotra A, Palmer KR, Stewart AE, Wallace EM, et al. Prematurity rates during the coronavirus disease 2019 (COVID-19) pandemic lockdown in Melbourne, Australia. Obstet Gynecol. 2021;137:405–7.CrossRef
20.
go back to reference Chawanpaiboon S, Vogel JP, Moller A-B, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2019;7(1):e37–46.CrossRef Chawanpaiboon S, Vogel JP, Moller A-B, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2019;7(1):e37–46.CrossRef
21.
go back to reference Schwartz DA, Dhaliwal A. Infections in pregnancy with COVID-19 and other respiratory RNA virus diseases are rarely, if ever, transmitted to the fetus: Experiences with coronaviruses, parainfluenza, metapneumovirus respiratory syncytial virus, and influenza. Arch Pathol Lab Med. 2020;144(8):920–8.CrossRef Schwartz DA, Dhaliwal A. Infections in pregnancy with COVID-19 and other respiratory RNA virus diseases are rarely, if ever, transmitted to the fetus: Experiences with coronaviruses, parainfluenza, metapneumovirus respiratory syncytial virus, and influenza. Arch Pathol Lab Med. 2020;144(8):920–8.CrossRef
22.
go back to reference Al-sheyab NA, Khader YS, Shattnawi KK, Alyahya MS, Batieha A. Neonatal mortality in Jordan: Rate, determinants, and causes using Jordan stillbirth and neonatal surveillance system. 29 April 2020, PREPRINT (Version 1). 10.21203/rs.3.rs-24128/v1. Accessed [12 Apr 2021]. Al-sheyab NA, Khader YS, Shattnawi KK, Alyahya MS, Batieha A. Neonatal mortality in Jordan: Rate, determinants, and causes using Jordan stillbirth and neonatal surveillance system. 29 April 2020, PREPRINT (Version 1). 10.21203/rs.3.rs-24128/v1. Accessed [12 Apr 2021].
23.
go back to reference Been JV, Sheikh A. COVID-19 must catalyse key global natural experiments. J Glob Health. 2020;10(1):010104.CrossRef Been JV, Sheikh A. COVID-19 must catalyse key global natural experiments. J Glob Health. 2020;10(1):010104.CrossRef
24.
go back to reference Philip RK, Purtill H, Reidy E, Daly M, Imcha M, McGrath D, et al. Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a ‘natural experiment’allowing analysis of data from the prior two decades. BMJ Glob Health. 2020;5(9):e003075.CrossRef Philip RK, Purtill H, Reidy E, Daly M, Imcha M, McGrath D, et al. Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a ‘natural experiment’allowing analysis of data from the prior two decades. BMJ Glob Health. 2020;5(9):e003075.CrossRef
25.
go back to reference Arnaez J, Ochoa-Sangrador C, Caserío S, Gutiérrez EP, del Pilar Jiménez M, Castañón L, et al. Lack of changes in preterm delivery and stillbirths during COVID-19 lockdown in a European region. Eur J Pediatr. 2021:1–6. Arnaez J, Ochoa-Sangrador C, Caserío S, Gutiérrez EP, del Pilar Jiménez M, Castañón L, et al. Lack of changes in preterm delivery and stillbirths during COVID-19 lockdown in a European region. Eur J Pediatr. 2021:1–6.
26.
go back to reference Li M, Yin H, Jin Z, Zhang H, Leng B, Luo Y, et al. Impact of Wuhan lockdown on the indications of cesarean delivery and newborn weights during the epidemic period of COVID-19. PLoS One. 2020;15:e0237420.CrossRef Li M, Yin H, Jin Z, Zhang H, Leng B, Luo Y, et al. Impact of Wuhan lockdown on the indications of cesarean delivery and newborn weights during the epidemic period of COVID-19. PLoS One. 2020;15:e0237420.CrossRef
27.
go back to reference Berghella V, Boelig R, Roman A, Burd J, Anderson K. Decreased incidence of preterm birth during coronavirus disease 2019 pandemic. Am J Obstet Gynecol. 2020;2:100258. Berghella V, Boelig R, Roman A, Burd J, Anderson K. Decreased incidence of preterm birth during coronavirus disease 2019 pandemic. Am J Obstet Gynecol. 2020;2:100258.
28.
go back to reference Been JV, Ochoa LB, Bertens LC, Schoenmakers S, Steegers EA, Reiss IK. Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study. Lancet Glob Health. 2020;5(11):e604–11.CrossRef Been JV, Ochoa LB, Bertens LC, Schoenmakers S, Steegers EA, Reiss IK. Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study. Lancet Glob Health. 2020;5(11):e604–11.CrossRef
29.
go back to reference Hedermann G, Hedley PL, Bækvad-Hansen M, Hjalgrim H, Rostgaard K, Poorisrisak P, et al. Danish premature birth rates during the COVID-19 lockdown. Arch Dis Childhood Fetal Neonatal Edn. 2021;106(1):93–5.CrossRef Hedermann G, Hedley PL, Bækvad-Hansen M, Hjalgrim H, Rostgaard K, Poorisrisak P, et al. Danish premature birth rates during the COVID-19 lockdown. Arch Dis Childhood Fetal Neonatal Edn. 2021;106(1):93–5.CrossRef
30.
go back to reference Wood R, Sinnott C, Goldfarb I, Clapp M, McElrath T, Little S. Preterm birth during the coronavirus disease 2019 (COVID-19) pandemic in a large hospital system in the United States. Obstet Gynecol. 2021;137:403–4.CrossRef Wood R, Sinnott C, Goldfarb I, Clapp M, McElrath T, Little S. Preterm birth during the coronavirus disease 2019 (COVID-19) pandemic in a large hospital system in the United States. Obstet Gynecol. 2021;137:403–4.CrossRef
31.
go back to reference Khalil A, Von Dadelszen P, Draycott T, Ugwumadu A, O’Brien P, Magee L. Change in the incidence of stillbirth and preterm delivery during the COVID-19 pandemic. JAMA. 2020;324:705–6.CrossRef Khalil A, Von Dadelszen P, Draycott T, Ugwumadu A, O’Brien P, Magee L. Change in the incidence of stillbirth and preterm delivery during the COVID-19 pandemic. JAMA. 2020;324:705–6.CrossRef
32.
go back to reference Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:73–6.CrossRef Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:73–6.CrossRef
33.
go back to reference Muhaidat N, Fram K, Thekrallah F, Qatawneh A, Al-Btoush A. Pregnancy during COVID-19 outbreak: The impact of lockdown in a middle-income country on antenatal healthcare and wellbeing. Int J Women's Health. 2020;12:1065–73.CrossRef Muhaidat N, Fram K, Thekrallah F, Qatawneh A, Al-Btoush A. Pregnancy during COVID-19 outbreak: The impact of lockdown in a middle-income country on antenatal healthcare and wellbeing. Int J Women's Health. 2020;12:1065–73.CrossRef
34.
go back to reference Ashish K, Gurung R, Kinney MV, Sunny AK, Moinuddin M, Basnet O, et al. Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. Lancet Glob Health. 2020;8:e1273–81.CrossRef Ashish K, Gurung R, Kinney MV, Sunny AK, Moinuddin M, Basnet O, et al. Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. Lancet Glob Health. 2020;8:e1273–81.CrossRef
35.
go back to reference Caniglia EC, Magosi LE, Zash R, Diseko M, Mayondi G, Mabuta J, et al. Modest reduction in adverse birth outcomes following the COVID-19 lockdown. Am J Obstet Gynecol. 2020;S0002-9378(20):32574–6. Caniglia EC, Magosi LE, Zash R, Diseko M, Mayondi G, Mabuta J, et al. Modest reduction in adverse birth outcomes following the COVID-19 lockdown. Am J Obstet Gynecol. 2020;S0002-9378(20):32574–6.
36.
go back to reference Debevec T, Burtscher J, Millet GP. Preterm birth: potential risk factor for greater COVID-19 severity? Respir Physiol Neurobiol. 2020;280:103484.CrossRef Debevec T, Burtscher J, Millet GP. Preterm birth: potential risk factor for greater COVID-19 severity? Respir Physiol Neurobiol. 2020;280:103484.CrossRef
Metadata
Title
Adverse pregnancy outcomes during the COVID-19 lockdown. A descriptive study
Authors
Eman F. Badran
Rula M. Darwish
Yousef Khader
Rama AlMasri
Mira Al Jaberi
Mohammad AlMasri
Farah AlSa’di
Leen abu Yosef
Noor al-Badaineh
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-04221-6

Other articles of this Issue 1/2021

BMC Pregnancy and Childbirth 1/2021 Go to the issue